US11266399B2 - Surgical suturing instruments - Google Patents

Abstract

A surgical suturing instrument includes first and second jaw members each defining a hole for detachable receipt of opposite ends of a curved needle. The first jaw member is rotatable relative to the second jaw member to move and transfer the curved needle between the jaw members. A first elongate locking element is slidable within the first jaw member between non-locking and locking positions. When the first elongate locking element is in the locking position and the curved needle is disposed within the hole of the first jaw member, a portion of the first elongate locking element is received in a notch defined in an end of the curved needle to selectively secure the curved needle to the first jaw member.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation-in-Part application of U.S. patent application Ser. No. 15/863,806, filed on Jan. 5, 2018, which claims the benefit of and priority to U.S. Provisional Application No. 62/462,512, filed on Feb. 23, 2017, the entire contents of each of which are incorporated by reference herein.

INTRODUCTION

Generally, endoscopic surgery involves incising through body walls for viewing and/or operating on a particular organ, such as, for example, the ovaries, uterus, gall bladder, bowels, kidneys, or appendix. Typically, trocars are utilized for creating an incision through which the endoscopic surgery is performed. Trocar tubes or cannula devices are extended into and left in place in the abdominal wall to provide access for endoscopic surgical tools. A camera or endoscope is inserted through a relatively large diameter trocar tube, which is generally located at the naval incision, and permits the visual inspection and magnification of the body cavity. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation, such as, forceps, cutters, applicators, or the like, which are designed to fit through additional cannulas.

In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to suture bodily organs or tissue. In the past, suturing of bodily organs or tissue through endoscopic surgery was achieved through the use of a sharp metal suture needle which had attached at one of its ends a length of suture material. The surgeon would cause the suture needle to penetrate and pass through bodily tissue, pulling the suture material through the bodily tissue. Once the suture material was pulled through the bodily tissue, the surgeon proceeded to tie a knot in the suture material. The knotting of the suture material allowed the surgeon to adjust the tension on the suture material to accommodate the particular tissue being sutured and control approximation, occlusion, attachment or other conditions of the tissue. The ability to control tension is extremely important to the surgeon regardless of the type of surgical procedure being performed.

SUMMARY

In accordance with one aspect of the disclosure, a surgical suturing instrument is provided and includes a handle assembly, a shaft extending distally from the handle assembly and defining a longitudinal axis, an end effector, and a first elongate locking element. The end effector includes a first jaw member and a second jaw member. The first jaw member is coupled to a distal end portion of the shaft and configured to rotate relative to and about the longitudinal axis of the shaft. The first jaw member defines a hole and a longitudinally-extending groove in communication with the hole. The hole is configured for detachable receipt of a curved needle. The second jaw member is coupled to a distal end portion of the shaft and defines a hole configured for detachable receipt of the curved needle. The first elongate locking element has a distal end portion slidably received in the groove. The first elongate locking element is configured to move between a proximal, non-locking position in which the distal end portion of the first elongate locking element is disposed proximally of the hole of the first jaw member, and a distal, locking position in which the distal end portion of the first elongate locking element is disposed within the hole of the first jaw member for locking the curved needle to the first jaw member.

In aspects, the second jaw member may define a longitudinally-extending groove in communication with the hole of the second jaw member.

In some aspects, the surgical suturing instrument may include a second elongate locking element having a distal end portion slidably received in the groove of the second jaw member. The second elongate locking element may be configured to move between a proximal, non-locking position in which the distal end portion of the second elongate locking element is disposed proximally of the hole of the second jaw member for releasing the curved needle, and a distal, locking position in which the distal end portion of the second elongate locking element is disposed within the hole of the second jaw member for locking the curved needle to the second jaw member.

In further aspects, the hole may define an axis that is perpendicular to an axis defined by the groove.

In other aspects, the surgical suturing instrument may include the curved needle. The curved needle may be configured for detachable receipt in the hole of each of the first and second jaw members.

In aspects, the curved needle may have a first end defining a first notch configured for receiving the distal end portion of the first elongate locking element when the first end is in the hole.

In some aspects, the curved needle may have a second end defining a second notch.

In further aspects, the surgical suturing instrument may further include a bearing assembly including an outer race and an inner race supported in the outer race. The first elongate locking element may have a proximal end portion coupled to the outer race or the inner race.

In other aspects, the surgical suturing instrument may include a push rod coupled to the other of the outer race or the inner race for moving the bearing assembly and the first elongate locking element between the proximal and distal positions.

In aspects, the end effector may include an outer body portion rotationally coupled to the distal end portion of the shaft. The first jaw member may be fixed to and extend from the outer body portion.

In some aspects, the end effector may include an inner body portion disposed within the outer body portion. The second jaw member may be coupled to a distal end portion of the inner body portion.

In further aspects, the surgical suturing instrument may include an actuation bar operably coupled to the handle assembly and configured to translate within the shaft in response to an actuation of the handle assembly. The outer body portion may define a cam slot having a portion of the actuation bar received therein such that translation of the actuation bar rotates the outer body portion and the first jaw member relative to the inner body portion and the second jaw member.

In accordance with another aspect of the disclosure, a surgical suturing instrument is provided and includes a handle assembly having a first trigger, a shaft extending distally from the handle assembly and defining a longitudinal axis, an end effector, and a first elongate locking element. The end effector includes a tubular outer body portion rotatably coupled to a distal end portion of the shaft, a first jaw member extending distally from the outer body portion, and a second jaw member. The first jaw member is configured to rotate with the outer body portion and relative to and about the longitudinal axis of the shaft. The first jaw member defines a hole configured for detachable receipt of a curved needle. The second jaw member is coupled to a distal end portion of the shaft and defines a hole configured for detachable receipt of the curved needle. The first elongate locking element has a proximal end portion coupled to the first trigger, and a distal end portion. The first elongate locking element is configured to move between a proximal, non-locking position in which the distal end portion of the first elongate locking element is disposed proximally of the hole of the first jaw member, and a distal, locking position in which the distal end portion of the first elongate locking element is disposed within the hole of the first jaw member for locking the curved needle to the first jaw member.

In aspects, the first jaw member may define a longitudinally-extending groove in communication with the hole of the first jaw member. The distal end portion of the first elongate locking element may be slidably disposed in the groove.

In some aspects, the surgical suturing instrument may include a second elongate locking element having a distal end portion slidably received in the second jaw member. The second elongate locking element may be configured to move between a proximal, non-locking position in which the distal end portion of the second elongate locking element is disposed proximally of the hole of the second jaw member for releasing the curved needle, and a distal, locking position in which the distal end portion of the second elongate locking element is disposed within the hole of the second jaw member for locking the curved needle to the second jaw member.

In further aspects, the surgical suturing instrument may include the curved needle. The curved needle may have a first end defining a first notch configured for receiving the distal end portion of the first elongate locking element when the first end is in the hole.

In other aspects, the curved needle may have a second end defining a second notch.

In aspects, the surgical suturing instrument may include a push rod and a bearing assembly. The push rod may have a proximal end portion coupled to the first trigger and may be configured to translate in response to an actuation of the first trigger. The bearing assembly may be disposed within the shaft and include an outer race and an inner race supported in the outer race. The proximal end portion of the first elongate locking element may be coupled to the outer race or the inner race and a distal end portion of the push rod may be coupled to the other of the outer race or the inner race for moving the bearing assembly and the first elongate locking element between the proximal and distal positions.

In some aspects, the end effector may include an inner body portion disposed within the outer body portion and rotationally fixed relative to the shaft. The second jaw member may be coupled to a distal end portion of the inner body portion.

In further aspects, the surgical suturing instrument may include an actuation bar operably coupled to a second trigger of the handle assembly and configured to translate within the shaft in response to an actuation of the second trigger. The outer body portion may define a cam slot having a portion of the actuation bar received therein such that translation of the actuation bar rotates the outer body portion and the first jaw member relative to the inner body portion and the second jaw member.

Further details and aspects of exemplary embodiments of the disclosure are described in more detail below with reference to the appended figures.

As used herein, the terms parallel and perpendicular are understood to include relative configurations that are substantially parallel and substantially perpendicular up to about + or −10 degrees from true parallel and true perpendicular.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other objects and features of the disclosure will become apparent from the following description of embodiments given in conjunction with the accompanying drawings, in which:

FIG. 1 is a perspective view of a surgical suturing instrument in accordance with the principles of the disclosure;

FIG. 2 is a perspective view of a handle assembly of the surgical suturing instrument ofFIG. 1;

FIG. 3 is a cross-sectional view, taken along line3-3 ofFIG. 1, of the surgical suturing instrument;

FIG. 4 is an enlarged view of detail4 ofFIG. 3 illustrating internal components of the handle assembly;

FIG. 5 is an enlarged view ofdetail5 ofFIG. 3 illustrating internal components of an end effector of the surgical suturing instrument;

FIG. 6A is a perspective view of an end effector of the surgical suturing instrument ofFIG. 1;

FIG. 6B is a perspective view, with parts removed, of the end effector ofFIG. 6A;

FIG. 6C is a perspective view, with additional parts removed, of the end effector ofFIG. 6B;

FIG. 6D is a perspective view, with additional parts removed, of the end effector ofFIG. 6C;

FIG. 7A is a perspective view of the end effector ofFIG. 6A illustrating jaw members thereof in a first position;

FIG. 7B is a perspective view of the end effector ofFIG. 6A illustrating the jaw members in a second position;

FIG. 8A is a perspective view of another embodiment of an end effector of a surgical suturing instrument;

FIG. 8B is a perspective view, with parts separated, of the end effector ofFIG. 8A;

FIG. 9A is a perspective view of the end effector ofFIG. 8A illustrating jaw members of the end effector in a closed configuration;

FIG. 9B is a perspective view of the end effector ofFIG. 9A illustrating the jaw members in an open configuration;

FIG. 9C is a perspective view of the end effector ofFIG. 9A illustrating the jaw members after a first jaw member of the jaw members has been rotated in a first direction;

FIG. 9D is a perspective view of the end effector ofFIG. 9A illustrating the jaw members after the first jaw member has been rotated in a second direction;

FIG. 9E is a perspective view of the end effector ofFIG. 9A illustrating the jaw members engaged to opposite ends of a curved needle;

FIG. 10A is a side view of an end effector of a surgical suturing instrument and a curved needle attached thereto illustrating jaw members of the end effector in a closed configuration with the curved needle in a stowed position;

FIG. 10B is a top view of the end effector ofFIG. 10A;

FIG. 11A is a side view of the end effector ofFIG. 10A illustrating the jaw members of the end effector in an open configuration;

FIG. 11B is a top view of the end effector ofFIG. 11A;

FIGS. 12A and 12B are alternate side views of the end effector ofFIG. 10A illustrating the jaw members in an open configuration with the curved needle splayed outwardly;

FIG. 12C is a top view of the end effector ofFIGS. 12A and 12B;

FIG. 13 is a perspective view of another embodiment of a surgical suturing instrument;

FIG. 14 is a perspective view, with parts removed, of a handle assembly of the surgical suturing instrument ofFIG. 13;

FIG. 15 is a perspective view, with parts separated, of the handle assembly ofFIG. 14;

FIG. 16 is a cross-sectional view, taken along line16-16 ofFIG. 13, with parts removed, of the surgical suturing instrument;

FIG. 17 is an enlarged view ofdetail17 shown inFIG. 16 with an actuation shaft added;

FIG. 18A is a perspective view of the end effector of the surgical suturing instrument ofFIG. 13;

FIG. 18B is a perspective view, with parts removed, of the end effector ofFIG. 18A;

FIG. 18C is a perspective view, with parts removed, of the end effector shown inFIG. 18B;

FIG. 19 is a schematic illustration of a robotic surgical system configured for use in accordance with the disclosure;

FIG. 20 is a side view illustrating another embodiment of a surgical suturing instrument;

FIG. 21 is a side perspective view illustrating an end effector and a bearing assembly of the surgical suturing instrument shown inFIG. 20;

FIG. 22 is a side perspective view illustrating jaw members of the end effector ofFIG. 21 in an approximated state for transferring a curved needle;

FIG. 23 is a side perspective view illustrating the jaw members ofFIG. 21 in a separated state;

FIG. 24 is a side, cross-sectional view illustrating an actuation bar for moving the end effector between the approximated and separated states;

FIG. 25 is an enlarged perspective view illustrating the first and second jaw members ofFIG. 21 transferring the curved needle therebetween;

FIG. 26 is a side, cross-sectional view illustrating a first elongate locking element locking the curved needle to the first jaw member ofFIG. 21;

FIG. 27 is an enlarged view illustrating the first elongate locking element ofFIG. 26 locking the curved needle to the first jaw member;

FIG. 28 is a plan view of the curved needle ofFIG. 22; and

FIG. 29 is a plan view of another embodiment of a curved needle.

DETAILED DESCRIPTION

Various embodiments of the presently disclosed surgical suturing instruments for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing will now be described in detail with reference to the drawings, wherein like reference numerals identify similar or identical elements. In the drawings and in the description that follows, the term “proximal” will refer to the portion of the surgical suturing instrument, or component thereof, that is closer to the user, while the term “distal” will refer to the portion of the surgical suturing instrument, or component thereof, that is farther from the user.

The minimally invasive surgical suturing instruments of the disclosure generally include a handle assembly or other suitable actuating mechanism, an elongate tubular body or shaft, and an end effector. The handle assembly is connected to a proximal portion of the elongate tubular body, and the end effector is operatively supported at a distal portion of the elongate tubular body, which allows the end effector to articulate in response to actuation of articulation cables, tethers, wires, rods, or the like. The end effector includes a curved suture needle and a pair of jaw members. In operation, the suture needle is passed back and forth through tissue from one jaw to another jaw by rotating one or both of the jaw members about a longitudinal axis defined by the elongate tubular body. The surgical suturing instruments described herein are configured for use with a curved needle having a suture attached thereto. The needle may include a groove formed near each end thereof. A suture may be secured to the surgical needle at a location between the grooves. The suture of needle may include a one-way or barbed suture, wherein the suture includes an elongated body having a plurality of barbs extending therefrom. The barbs are oriented in such a way that the barbs cause the suture to resist movement in an opposite direction relative to the direction in which the barb faces.

With reference toFIG. 1, a surgical suturing instrument in accordance with an embodiment of the disclosure is identified generally as100.Surgical suturing instrument100 is adapted to be particularly useful in endoscopic or laparoscopic procedures, wherein anend effector130 of thesurgical suturing instrument100 is insertable into a surgical site, via a cannula assembly or the like.Surgical suturing instrument100 includes ahandle assembly110, ashaft120 extending distally fromhandle assembly110, and anend effector130 that extends from adistal portion120bofshaft120.

With reference toFIGS. 1-4, handleassembly110 ofsurgical suturing instrument100 includes ahandle housing111 that supports both anactuation assembly117 and anarticulation assembly119. Handlehousing111 has a fixedhandle113 and abarrel portion115 extending substantially perpendicularly fromhandle113. Handle113 has anarticulation wheel121 ofarticulation assembly119 rotatably supported therein or thereon.Barrel portion115 ofhandle housing111 has acavity125 for slidable receipt ofactuation assembly117.

Actuation assembly117 ofhandle assembly110 includes atrigger127, anactuation shaft129, and apin131 attached to aproximal portion129aofactuation shaft129.Pin131 is fixed to trigger127 andproximal portion129aofactuation shaft129 is fixed to pin131 such that movement oftrigger127 relative to handlehousing111 movespin131 and, in turn,actuation shaft129, throughbarrel portion115.Actuation shaft129 ofactuation assembly117 extends perpendicularly frompin131, throughcavity125 ofbarrel portion115, and terminates in adistal portion129bthat is operably coupled to endeffector130 in a manner to rotatejaw members134,136 of theend effector130 upon actuation oftrigger127, as will be described in detail below.

Articulation assembly119 ofhandle assembly110 includes arotation wheel121 and a first rod orshaft137 operably coupled torotation wheel121 at aproximal portion137aoffirst rod137.First rod137 has adistal portion137battached to aproximal portion139aof asecond rod139 that extends throughshaft120.Second rod139 ofarticulation assembly119 has adistal portion139b(FIG. 5) pinned to endeffector130 at a location adjacent an articulation joint, for example, anarticulation pin138. In particular,second rod139 ofarticulation assembly119 is spaced radially outward of articulation pin138 (i.e., offset from a central longitudinal axis of shaft120) such that longitudinal movement of first andsecond rods137,139, via rotation ofrotation wheel121, effects an articulation ofend effector130 relative toshaft120 aboutarticulation pin138 in one of two opposing directions.

Surgical suturing instrument100 further includes a rotation knob orrotation housing147.Rotation knob147 is rotationally fixedly disposed about aproximal portion120aofshaft120 such that a rotation ofrotation knob147 effects a rotation ofshaft120 about longitudinal axis “X” ofshaft120.

With reference toFIGS. 1 and 4-7B,shaft120 ofsurgical suturing instrument100 has aproximal portion120adisposed withincavity125 ofhandle housing111 and adistal portion120b.End effector100 ofsurgical suturing instrument100 is pivotably coupled todistal portion120bofshaft120.End effector130 generally includes anelongated body portion132 and first andsecond jaw members134,136 each non-pivotably coupled to a distal portion ofbody portion132. In some embodiments,jaw members134,136 may be pivotably coupled to the distal portion ofbody portion132.Body portion132 has a proximal portion pivotably coupled todistal portion120bofshaft120 ofsurgical suturing instrument100 via thearticulation pin138 mentioned above. As such,end effector130 is articulatable relative toshaft120 about thearticulation pin138 via the articulation assembly119 (FIG. 1) described above.

In some embodiments, instead ofarticulation assembly119 being responsible for articulatingend effector130,body portion132 may be pivoted or articulated relative toshaft120 using a pair of cables (not shown) that extend fromhandle assembly110 and connect to opposite sides ofbody portion132 ofend effector130. In operation, as one cable is pulled proximally, the other cable is pushed distally (or let out) to articulateend effector130 relative toshaft120.

With continued reference toFIGS. 1 and 4-7B,body portion132 ofend effector130 includes a rotatableouter shaft140 and a rotatableinner shaft142 disposed withinouter shaft140.Outer shaft140 hasfirst jaw member134 coupled to a distal portion thereof, andinner shaft142 hassecond jaw member136 coupled to a distal portion thereof such that first andsecond jaw members134,136 rotate with a rotation of inner andouter shafts140,142 about a longitudinal axis defined bybody portion132, as will be described below. Adistal portion142bofinner shaft142 extends distally beyond adistal portion140bofouter shaft140.First jaw member134 is longer thansecond jaw member136 by a length substantially equal to a length thatdistal portion142bofinner shaft142 extends distally beyonddistal portion140bofouter shaft140. As such, the distal ends of first andsecond jaw members134,136 are aligned with one another to facilitate an exchange of asuture needle10 therebetween.

Outer shaft140 ofbody portion132 defines ahelical cam slot144 formed therein. In some embodiments,cam slot144 may assume a variety of patterns, for example, zig-zag, undulating, or the like.End effector130 includes anactuation bar146 that is configured to translate along the longitudinal axis ofbody portion132 in response to an actuation oftrigger127 ofhandle assembly110. In particular,actuation bar146 has aproximal portion146aoperably coupled todistal portion129b(FIG. 5) ofactuation shaft129 ofhandle assembly110. In some embodiments,actuation shaft129 ofhandle assembly110 andactuation bar146 ofend effector130 are integrally formed with one another.Actuation shaft129 ofhandle assembly110 is coupled toactuation bar146 via a flexibleelongate member149 disposed at a locationadjacent articulation pin138 ofshaft120 so that asend effector130 articulates relative toshaft120,actuation bar146 bends relative toactuation shaft129 about flexibleelongate member149. In some embodiments,actuation shaft129 andactuation bar146 are each formed from a flexible material permittingactuation bar146 to flex relative toactuation shaft129 during articulation ofend effector130

Actuation bar146 ofend effector130 has a distal portion in the form of a T-shapedcam146bhaving afirst projection151athat is slidably received withincam slot144 ofouter shaft140. Upon the axial translation ofactuation bar146 relative tobody portion132 ofend effector130,first projection151aofcam146bofactuation bar146 moves throughcam slot144 ofouter shaft140 to rotateouter shaft140 about the longitudinal axis ofbody portion132 and, in turn, rotatefirst jaw member134.

Inner shaft142 ofbody portion132 also defines ahelical cam slot150 formed therein.Cam slot150 ofinner shaft142 is angled relative tocam slot144 of outer shaft140 (e.g.,cam slots144,150 run in opposing helical directions relative to one another).Projection151aofcam146bofactuation bar146 also extends throughcam slot150 ofinner shaft142. Sincecam slots144,150 of outer andinner shafts140,142 run in opposing directions, asactuation bar146 is translated withinbody portion132 ofend effector130, outer andinner shafts140,142 are rotated in opposite directions and, in turn, first andsecond jaw members134,136 are rotated in opposite directions.

Inner shaft142 may define anothercam slot153 disposed on an opposite side ofinner shaft142 fromcam slot150. Asecond projection151bofcam148 may extend throughsecond cam slot153 ofinner shaft142 to facilitate rotation ofinner shaft142 and resist rotation ofactuation bar146.

In some embodiments,surgical suturing instrument100 may include a second actuation bar (not shown) that is operably coupled to another trigger (not shown) ofhandle assembly110. Instead ofcam146bofactuation bar146 extending throughcam slot150 ofinner shaft142, the second actuation bar may have a projection or cam at its distal end that extends throughcam slot150 ofinner shaft142. As such, inner andouter shafts140,142 may be independently rotated relative to one another using their respective actuation bars.

With reference toFIGS. 7A and 7B, first andsecond jaw members134,136 each have a proximal portion and a distal portion. The proximal portion of each of the first andsecond jaw members134,136 is coupled toouter shaft140 andinner shaft142, respectively. In some embodiments, first andsecond jaw members134,136 may be pivotably connected tobody portion132 via a joint, for example, a hinge or a knuckle/clevis. The distal portion of each of the first andsecond jaw members134,136 defines a hole oraperture156,158 therein sized and dimensioned for detachable and/or selective receipt of an end of acurved suture needle10.Holes156,158 extend entirely through a thickness of first andsecond jaw members134,136, respectively. In some embodiments, holes156,158 may only extend partially through a thickness of first andsecond jaw members134,136.

Holes156,158 are configured to selectively retain an end ofcurved needle10 therein such thatneedle10 may be passed to and from first andsecond jaw members134,136 during a surgical procedure. In particular, each of theholes156,158 may have disposed therein a touch latch or push latch (not explicitly shown) having pivotable engagement portions or hooks for selectively engaging and releasing opposing ends ofcurved needle10. In addition, each opposing end of thecurved needle10 may have a hole or recess defined therein configured to selectively engage the push latch disposed in each of theholes156,158 ofjaw members134,136.

For example, withjaw members134,136 in a starting position, a first end ofcurved needle10 is engaged to the push latch offirst jaw member134 such that the first end ofcurved needle10 is temporarily fixed tofirst jaw member134, whilesecond jaw member136 is spaced fromfirst jaw member134 and disengaged from a second end ofcurved needle10. Upon approximation ofjaw members134,136, the second end ofcurved needle10 engages an interior wall that defineshole158 ofsecond jaw member136 to apply pressure on the push latches of both the first andsecond jaw members134,136. This pressure applied on the push latches by opposing first and second ends of thecurved needle10 actuates the push latches to simultaneously cause the push latch offirst jaw member134 to disengage the first end of thecurved needle10 and the push latch of thesecond jaw member136 to engage the second end of thecurved needle10. Upon spacing or separating the first andsecond jaw members134,136, thecurved needle10 stays attached to thesecond jaw member136 and is released from thefirst jaw member134.

In some embodiments, rather thanholes156,158 having push latches for selectively attaching and detachingcurved needle10 tojaw members134,136, holes156,158 may have a magnetic semiconductor (not shown) disposed therein. The semiconductors are of the type that can have their magnetism selectively turned on and off by selectively applying a voltage thereto using the phenomenon known as electrically induced ferromagnetism. In particular,surgical suturing instrument100 may include two wires (not shown) extending from a generator (not shown) disposed in handle assembly110 (or coupled to handle assembly110) and terminating at a respective semiconductor injaw members134,136. The generator ofhandle assembly110 may apply a voltage to the semiconductor offirst jaw member134 via the wire to turn on the magnetism of the semiconductor offirst jaw member134 when it is desired to havecurved needle10 retained infirst jaw member134. To passcurved needle10 fromfirst jaw member134 tosecond jaw member136, the magnetism of the semiconductor offirst jaw member134 is turned off to release a metallic first end ofcurved needle10 fromfirst jaw member134. Concurrently with turning the magnetism of the semiconductor offirst jaw member134 off, the magnetism of the semiconductor ofsecond jaw member136 is turned on to retain a metallic second end ofcurved needle10 inhole158 ofsecond jaw member136.

In some embodiments, instead of using magnetic semiconductors to selectively retaincurved needle10 injaw members134,136,surgical suturing instrument100 may include wires or thin cables (not shown) that extend through channels defined through first andsecond jaw members134,136. The wires are fabricated from an elastic, malleable material, for example, an elastomer, a shape memory alloy or a shape memory plastic. The wires are configured to move in opposite longitudinal directions through the channels defined throughjaw members134,136 to selectively pass in and out ofholes156,158 of first andsecond jaw members134,136. Distal ends of the wires are configured to interlock with an aperture or indentation (not shown) defined in opposite ends ofcurved needle10 to preventcurved needle10 from detaching from the selectedjaw member134 or136. In particular, as one wire moves into ahole156 or158 of itsrespective jaw member134 or136, the other wire moves out of thehole156 or158 of itsrespective jaw member134 or136. In this way,curved needle10 may be detachably retained within either of the first andsecond jaw members134,136 due to the engagement of a distal end of one of the wires with an end of thecurved needle10.

In operation, to perform a minimally invasive procedure involving a suturing of tissue, for example, a hernia repair, an access tube or cannula is positioned through surface tissue of a patient to gain access to the surgical site within a body of the patient.Surgical suturing instrument100 is passed through the cannula to positionjaw members134,136, withcurved needle10, adjacent the subject tissue. To pass curved needle10 (having a suture attached thereto) through the tissue to suture the tissue,jaw members134,136 are rotated from a spaced-apart position to an approximated position.

To rotatejaw members134,136 about the longitudinal axis ofbody portion132 ofend effector130, trigger127 ofhandle assembly110 is actuated to moveactuation shaft129 ofhandle assembly110 in a proximal direction. Due toactuation bar146 ofend effector130 being coupled toactuation shaft129 ofhandle assembly110, proximal movement of actuation shaft effects proximal movement ofactuation bar146 throughbody portion132.Cam146bofactuation bar146 moves throughcam slots144,150 of outer andinner shafts140,142, respectively, to drive a rotation of outer andinner shafts140,142 in opposing directions, indicated by arrows “A” and “B” ofFIG. 7A. Sincejaw members134,136 are coupled to outer andinner shafts140,142, respectively,jaw members134,136 are rotated with outer andinner shafts140,142 toward one another to driveneedle10 along a circular pathway around longitudinal axis “X” ofbody portion132 through the tissue.

Rotation ofjaw members134,136 is continued untilhole158 ofsecond jaw member136 receives an end ofcurved needle10.Curved needle10 is transferred fromfirst jaw member134 tosecond jaw member136 using the touch latches described above, or any other suitable mechanism. Withcurved needle10 connected tosecond jaw member136,trigger127 is released, allowing a spring (not shown) to movetrigger127 to the unactuated position, thereby movingactuation shaft129 of handle assembly in a distal direction back to the starting position. Distal movement of theactuation shaft129 pushes or drivesactuation bar146 ofend effector130 in the distal direction throughbody portion132 ofend effector130. Movement ofactuation bar146 in the distal direction movescam146bofactuation bar146 throughcam slots144,150 of outer andinner shafts140,142 to drive a rotation of outer andinner shafts140,142, and in turn, first andsecond jaw members134,136, away from one another, in the direction indicated by arrows “C” and “D” inFIG. 7B. This process may be continued until the subject tissue is sutured.

With reference toFIGS. 8A-9E, another embodiment of anend effector230 of a surgical suturing instrument is provided.End effector230 is similar to endeffector130 described above with reference toFIGS. 1-7B with a difference being thatend effector230 is configured to rotate only one of its jaw members about a longitudinal axis defined byend effector230. Thus,end effector230 will only be described in the detail necessary to elucidate particular differences between the embodiments.

End effector230 may be remotely operable by a handle assembly, for example, thehandle assembly110 ofFIG. 1, or any other suitable actuating mechanism.End effector230 generally includes anelongated body portion232 and first andsecond jaw members234,236 each pivotably coupled to a distal portion ofbody portion232. Unlikeend effector130 described above,end effector230 is configured to rotate onlyfirst jaw member234 about a longitudinal axis “X” defined bybody portion232 rather than both first andsecond jaw members234,236.

Body portion232 ofend effector230 has a proximal portion configured to be pivotably coupled to a distal portion of a shaft, for example,shaft120 ofFIG. 1. As such,end effector230 is articulatable relative toshaft120.Body portion232 ofend effector230 includes a rotatableouter shaft240 and aninner shaft242 disposed withinouter shaft240.Outer shaft240 hasfirst jaw member234 pivotably coupled to adistal portion240bthereof via apivot pin241, andinner shaft242 hassecond jaw member236 pivotably coupled to adistal portion242bthereof via apivot pin243.Distal portion242bofinner shaft242 extends distally beyonddistal portion240bofouter shaft240 to allow forsecond jaw member236 to pivot outwardly frombody portion232 without interference fromdistal portion240bofouter shaft240.

Outer shaft240 defines ahelical cam slot244 formed therein. In some embodiments,cam slot244 may assume a variety of patterns, for example, zig-zag, undulating, or the like.End effector230 includes anactuation bar246 that is configured to translate along longitudinal axis “X” ofbody portion232 in response to an actuation oftrigger127 of handle assembly110 (FIG. 1). Theactuation bar246 extends through a pin orcam248 that is slidably received withincam slot244 ofouter shaft240. Upon the axial translation of theactuation bar246 relative tobody portion232 ofend effector230,cam248 is moved throughcam slot244 ofouter shaft240 to causeouter shaft240 to rotate about longitudinal axis “X” ofbody portion232 and, in turn, rotatefirst jaw member234 to or away fromsecond jaw member236.

Distal portion240bofouter shaft240 defines a longitudinally-extendingslot252. Whenfirst jaw member234 is in the closed configuration, as shown inFIG. 9A,first jaw member234 extends throughslot252 ofouter shaft240.Inner shaft242 defines alongitudinally extending slot253 in an intermediate portion thereof.Cam248 extends throughslot253 ofinner shaft242 and is guided along the longitudinal axis “X” byslot253 during actuation ofcam248 by theactuation bar246.Inner shaft242 also defines a transversely-extendingslot254 located atdistal portion242bofinner shaft242. When outer andinner shafts240,242 are in a first position, as shown inFIG. 9A, slot254 ofinner shaft242 is aligned withslot252 ofouter shaft240 to form one continuous elongated slot for receipt offirst jaw member234. In some embodiments,distal portion240bofouter shaft240 and/ordistal portion242bofinner shaft242 may have additional slots formed therein.

Theinner shaft242 has aproximal portion242athat is operably coupled to an actuation mechanism (not shown) ofhandle assembly110. In this way,inner shaft242 ofend effector230 may be longitudinally movable relative toouter shaft240 in either a proximal or distal direction. It is contemplated thatdistal portion242bofinner shaft242 has ramped surfaces such that proximal movement ofinner shaft242 relative to first andsecond jaw members234,236 raises first andsecond jaw members234,236 from the first position, in whichfirst jaw member234 extends throughslots252,254, to a second position, in which first andsecond jaw members234,236 are splayed outwardly relative tobody portion232, as shown inFIG. 9B. In some embodiments,end effector230 may include any suitable mechanism capable of pivotingjaw members234,236 relative to one another. It is contemplated thatend effector230 includes a biasing element, for example, a spring, that resilientlybiases jaw members234,236 toward the first, closed position.

A distal portion of each of the first andsecond jaw members234,236 defines a hole oraperture256,258 therein, similar toholes156,158 ofjaw members134,136 described above.Holes256,248 extend entirely through a thickness of first andsecond jaw members234,236, respectively. In some embodiments, holes256,258 may only extend partially through a thickness of first andsecond jaw members234,236.Holes256,258 are configured to selectively retain an end ofcurved needle10 therein such thatneedle10 may be passed to and from first andsecond jaw members234,236 during a surgical procedure. This may be accomplished using any of the mechanisms described above, for example, push latches.

In operation, to perform a minimally invasive procedure involving suturing tissue, for example, a hernia repair, an access tube or cannula is positioned through surface tissue of a patient to gain access to a surgical site within a body of the patient. First andsecond jaw members234,236 ofend effector230 are moved to the closed configuration, in which first andsecond jaw members234,236 are parallel with longitudinal axis “X” ofbody portion232 and are nested withinslots252,254 of outer andinner shafts240,242 ofbody portion232. With first andsecond jaw members234,236 in the closed configuration,end effector230 is passed through the cannula to positionjaw members234,236, withcurved needle10, adjacent the subject tissue.Inner shaft242 ofbody portion232 is moved proximally relative toouter shaft240, thereby moving ramped surfaces (not shown) ofinner shaft242 proximally along first andsecond jaw members234,236 to pivotjaw members234,236 away from one another to the open configuration.

Withjaw members234,236 in the open configuration and the distal portion offirst jaw member234 outside ofslots252 and254 of each of the outer andinner shafts240,242 ofbody portion232, theactuation bar246 is moved in a distal direction throughbody portion232. As theactuation bar246 is moved distally,cam248 moves distally throughcam slot244 ofouter shaft240 to drive a rotation ofouter shaft240 relative toinner shaft242, in a direction indicated by arrow “E” inFIG. 9C. Sincefirst jaw member234 is coupled toouter shaft240,first jaw member234 is rotated withouter shaft240 towardsecond jaw member236 to driveneedle10 through tissue along a circular pathway around longitudinal axis “X” ofbody portion232. Rotation offirst jaw member234 is continued untilhole258 ofsecond jaw member236 receives an opposite or second end ofcurved needle10.Curved needle10 is transferred fromfirst jaw member234 tosecond jaw member236.

Withcurved needle10 connected tosecond jaw member236, theactuation bar246 may be actuated to move theactuation bar246 in a proximal direction throughbody portion232 ofend effector230. Movement of theactuation bar246 in a proximal direction proximally movescam248 throughcam slot244 ofouter shaft240 to drive a rotation ofouter shaft240, and in turn,first jaw member236, away fromsecond jaw member236. This process may be continued until the subject tissue is sutured.

With reference toFIGS. 10A-12C, anend effector330 of a surgical suturing instrument, similar tosurgical suturing instrument100 described above with reference toFIGS. 1-9E, is provided.End effector330 is similar to either of theend effectors130,230 described above with reference toFIGS. 1-9E. Thus,end effector330 will only be described in the detail necessary to elucidate particular differences between the embodiments.End effector330 may be remotely operable by a handle assembly, for example, thehandle assembly110 ofFIG. 1, or any other suitable actuating mechanism.

End effector330 includes abody portion332 and first andsecond jaw members334,336 pivotably coupled tobody portion332. A distal portion of each of the first andsecond jaw members334,336 defines a hole oraperture356,358 therein, similar toholes156,148 described above.Holes356,358 extend entirely through a thickness of first andsecond jaw members334,336. In some embodiments, holes356,358 may only extend partially through a thickness of first andsecond jaw members334,336.Holes356,358 are configured to selectively retain an end of acurved needle10 therein such thatneedle10 may be passed to and from first andsecond jaw members334,336 during a surgical procedure.

End effector330 includes a cup member, such as, for example, a nest in the form of a ball-shaped element, pivotably disposed withinhole356 offirst jaw member334. It is contemplated thatend effector330 may include a second nest pivotably disposed withinhole358 ofsecond jaw member336. Nest is configured to hold an end ofcurved needle10 therein and to pivot relative tofirst jaw member334, thereby pivotingcurved needle10 relative tofirst jaw member334. It is contemplated thatend effector330 may include an actuator rod (not shown) operably coupled to the handle assembly110 (FIG. 1) and operably coupled to nest such that actuation of the actuator rod pivots the nest withinhole356 and relative tofirst jaw member334.

In operation, to perform a minimally invasive procedure involving suturing tissue, for example, a hernia repair, an access tube or cannula is positioned through surface tissue of a patient to gain access to a surgical site within a body of the patient. First andsecond jaw members334,336 ofend effector330 are moved to the closed configuration, in which first andsecond jaw members334,336 are parallel withbody portion332. Nest offirst jaw member334 is manipulated so thatcurved needle10 is disposed adjacent or in abutting engagement withjaw members334,336, as shown inFIGS. 10A and 10B. Withcurved needle10 adjacentfirst jaw member334, the overall profile ofend effector330 is reduced allowingend effector330 to be passed through a smaller dimensioned cannula or access tube.

With first andsecond jaw members334,336 in the closed configuration and thecurved needle10 side-by-side withfirst jaw member334,end effector330 is passed through the cannula to positionjaw members334,336, withcurved needle10, adjacent the subject tissue.Jaw members334,336 are pivoted away from one another to the open configuration in preparation for suturing tissue, as shown inFIGS. 11A and 11B.

With reference toFIGS. 12A-12C, withjaw members334,336 in the open configuration, the actuator rod ofend effector330 is actuated to rotate nest, thereby rotatingcurved needle10 outwardly away fromfirst jaw member334, in the direction indicated by arrow “F” inFIG. 12B.Curved needle10 is rotated via nest until an axis defined bycurved needle10 is aligned withholes356,358 of each of first andsecond jaw members334,336. In some embodiments, an ancillary surgical instrument, for example, a grasper, may be provided to manually rotatecurved needle10 outwardly relative tofirst jaw member334.First jaw member334 and/orsecond jaw member336 may be rotated to driveneedle10 through tissue in a similar manner as that described above.

With reference toFIGS. 13-18C, another embodiment of a surgical suturing instrument is illustrated and identified generally as400.Surgical suturing instrument400 is similar tosurgical suturing instrument100 described above, and will therefore only be described with the detail necessary to elucidate particular differences therebetween.Surgical suturing instrument400 includes ahandle assembly410, ashaft420 extending distally fromhandle assembly410, and anend effector430 that extends from adistal portion420bofshaft420.

Handle assembly410 ofsurgical suturing instrument400 includes ahandle housing411 supporting anactuation assembly417 and anarticulation assembly419. Handlehousing411 has ahandle413 and abarrel portion415 extending substantially perpendicularly fromhandle413. Handle413 has anarticulation wheel421 ofarticulation assembly419 rotatably supported therein. Barrel portion414 ofhandle housing411 has a longitudinally-extendingslot423 defined therein and acavity425 defined therein.

Actuation assembly417 ofhandle assembly410 includes atrigger427, anactuation shaft429, and apin429aattached to a proximal portion ofactuation shaft429. Slot423 ofbarrel portion415 has thepin429aofactuation assembly417 extending transversely therethrough. Pin429 also extends within a vertically-orientedslot433 defined intrigger427 such that movement oftrigger427 relative to handlehousing411 moves pin429athroughslot423 ofbarrel portion415.Actuation shaft429 ofactuation assembly417 extends perpendicularly frompin429a, throughcavity425 ofbarrel portion415, and terminates in adistal portion429bthat is operably coupled to endeffector430 in a manner to rotatejaw members434,436 of theend effector430 upon actuation oftrigger427, as will be described in detail below.

Articulation assembly419 ofhandle assembly410 includes anelongate member437, anarticulation bar439 extending distally from theelongate member437, and thearticulation wheel421, which is rotatably supported inhandle413 ofhandle housing411. Theelongate member437 ofarticulation assembly419 has aproximal portion437aand a tubulardistal portion437b. Theproximal portion437aof theelongate member437 has apin441 extending therefrom that is received in achannel443 defined inarticulation wheel421.Channel443 ofarticulation wheel421 spirals radially inward/outward about a rotation axis ofarticulation wheel421 and has two opposite ends defined by twoopposite end walls445a,445b.Pin441 ofelongate member437 is disposed a radial distance away from the axis about whicharticulation wheel421 rotates. In some embodiments, pin441 ofelongate member437 may be disposed above/below the axis about whicharticulation wheel421 rotates. In operation, a rotation ofarticulation wheel421 brings one of theend walls445a,445bofchannel443 ofarticulation wheel421 into engagement withpin441 ofelongate member437 to drive one of a proximal or distal movement ofelongate member437 throughbarrel portion415 ofhandle housing111.

With reference toFIGS. 15-17,articulation shaft439 ofarticulation assembly419 has aproximal portion439adisposed within tubulardistal portion437bofelongate member437 and is fixed to an inner surface thereof such thatarticulation shaft439 moves withelongate member437.Articulation shaft439 ofarticulation assembly419 has adistal portion439boperably coupled to endeffector430 at a location adjacent an articulation joint, for example, anarticulation pin438. In particular,articulation shaft439 ofarticulation assembly419 is spaced radially outward of articulation pin438 (i.e., offset from a central longitudinal axis of shaft420) such that longitudinal movement ofarticulation shaft439, via rotation ofrotation wheel421, effects an articulation ofend effector430 relative toshaft420 aboutarticulation pin438 in one of two opposing directions.

Handle assembly410 further includes arotation wheel447 disposed about and rotationally fixed toshaft420 ofsurgical suturing instrument400. In this way,shaft420 ofsurgical suturing instrument400 rotates about its longitudinal axis in response to a rotation ofrotation wheel447.Shaft420 ofsurgical suturing instrument400 has aproximal portion420adisposed withincavity425 ofhandle housing411 and adistal portion420b.End effector400 ofsurgical suturing instrument400 is pivotably coupled todistal portion420bofshaft420.

With reference toFIGS. 17 and 18A-18C,end effector430 generally includes anelongated body portion432 and first andsecond jaw members434,436 each pivotably coupled tobody portion432 ofend effector430. In some embodiments,jaw members434,436 may be non-pivotable in relation tobody portion432 or, in other embodiments, only one ofjaw members434,436 may be pivotable in relation tobody portion432.Body portion432 has a proximal portion pivotably coupled todistal portion420bofshaft420 ofsurgical suturing instrument400 via thearticulation pin438 mentioned above. As such,end effector430 is articulatable relative toshaft420 about thearticulation pin438 via the articulation assembly419 (FIG. 13) described above.

Body portion432 ofend effector420 includes a rotatableouter shaft440 and aninner shaft442 non-rotatably disposed withinouter shaft440.Outer shaft440 hasfirst jaw member434 coupled to a distal portion thereof, andinner shaft442 hassecond jaw member436 coupled to a distal portion thereof, such thatfirst jaw member434 rotates relative tosecond jaw member436 with a rotation ofouter shaft440.Outer shaft440 ofbody portion432 defines ahelical cam slot444 formed therein. In some embodiments,cam slot444 may assume a variety of patterns, for example, zig-zag, undulating, or the like.End effector430 includes an actuation bar446 that is configured to translate along a longitudinal axis ofbody portion432 in response to an actuation oftrigger427 ofhandle assembly410.

In particular, actuation bar446 has aproximal portion446a(FIG. 17) coupled todistal portion429bofactuation rod429 ofhandle assembly410. In some embodiments,actuation shaft429 ofhandle assembly410 and actuation bar446 ofend effector430 are integrally formed with one another.Actuation shaft429 ofhandle assembly410 is coupled to actuation bar446 via a flexible elongate member449 disposed at a locationadjacent articulation pin438 ofshaft420 so that asend effector430 articulates relative toshaft420, actuation bar446 bends relative toactuation shaft429 about flexible elongate member449. In some embodiments,actuation shaft429 and actuation bar446 are each formed from a flexible material permitting actuation bar446 to flex relative toactuation shaft429 during articulation ofend effector430.

Actuation bar446 has adistal portion446bhaving a projection orcam448 that is slidably received withincam slot444 ofouter shaft440. Upon the axial translation of actuation mechanism446 relative tobody portion432,projection448 moves throughcam slot444 ofouter shaft440 to rotateouter shaft440 about the longitudinal axis ofbody portion432 and, in turn, rotatefirst jaw member434.

Inner shaft442 ofbody portion432 is pivotably coupled todistal portion420bofshaft420 via a joint, for example, thearticulation pin438, while being non-rotatable relative toshaft420 about longitudinal axis ofshaft420.Jaw member436 is pivotably coupled to a distal portion ofinner shaft442. In this way,inner shaft442 rendersend effector430 articulatable relative toshaft420 while preventingjaw member434 from rotation relative toinner shaft442 about the longitudinal axis ofbody portion432.Inner shaft442 ofbody portion432 defines a longitudinally-extending slot450 havingcam448 of actuation bar446 extending therethrough. Slot450 ofinner shaft442 acts to guidecam448 in a straight line throughbody portion432.

With continued reference toFIGS. 18A-18C, a distal portion of each of the first andsecond jaw members434,436 defines a hole oraperture456,458 therein, similar toholes156,158 described above.Holes456,448 extend entirely through a thickness of first andsecond jaw members434,436, respectively. In some embodiments, holes456,458 may only extend partially through a thickness of first andsecond jaw members434,436.Holes456,458 are configured to selectively retain an end ofcurved needle10 therein such thatneedle10 may be passed to and from first andsecond jaw members434,436 during a surgical procedure. This may be accomplished using any of the mechanisms described above, for example, push latches.

In operation, to perform a minimally invasive procedure involving suturing tissue, for example, a hernia repair, an access tube or cannula is positioned through surface tissue of a patient to gain access to a surgical site within a body of the patient.End effector430 is passed through the cannula to positionjaw members434,436, withcurved needle10, adjacent the subject tissue. The actuation bar446 ofend effector430 is moved in a distal direction throughbody portion232 in response to an actuation oftrigger427. As the actuation bar446 is moved distally,cam448 moves distally throughcam slot444 ofouter shaft440 to drive a rotation ofouter shaft440 relative toinner shaft442. Sincefirst jaw member434 is coupled toouter shaft440,first jaw member434 is rotated withouter shaft440 towardsecond jaw member436 to driveneedle10 through tissue along a circular pathway around the longitudinal axis ofbody portion432. Rotation offirst jaw member434 is continued untilhole458 ofsecond jaw member436 receives an end ofcurved needle10 to transfercurved needle10 fromfirst jaw member434 tosecond jaw member436.

Withcurved needle10 connected tosecond jaw member436, the actuation bar446 may be actuated to move the actuation bar446 in a proximal direction throughbody portion432 ofend effector430. Movement of the actuation bar446 in a proximal direction movescam448 in the proximal direction throughcam slot444 ofouter shaft440 to drive a rotation ofouter shaft440, and in turn,first jaw member436, away fromsecond jaw member436. This process may be continued until the subject tissue is sutured.

The surgical suturing instruments, or end effectors thereof, described herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the surgical suturing instruments, or component thereof, disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.

With reference toFIG. 19, one exemplary robotic surgical system ormedical workstation1000 may generally include a plurality ofrobot arms1002,1003; acontrol device1004; and anoperating console1005 coupled withcontrol device1004.Operating console1005 may include adisplay device1006, which may be set up in particular to display three-dimensional images; andmanual input devices1007,1008, by means of which a person (not shown), for example a surgeon, may be able to telemanipulaterobot arms1002,1003 in a first operating mode.

Each of therobot arms1002,1003 may include a plurality of members, which are connected through joints, and an attachingdevice1009,1011, to which may be attached, for example, a surgical tool “ST” supporting anend effector1100, in accordance with any one of several embodiments ofend effectors130,230,330, or430 disclosed herein, as will be described in greater detail below.

Robot arms1002,1003 may be driven by electric drives (not shown) that are connected to controldevice1004. Control device1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way thatrobot arms1002,1003, their attachingdevices1009,1011 and thus the surgical tool (including end effector1100) execute a desired movement according to a movement defined by means ofmanual input devices1007,1008.Control device1004 may also be set up in such a way that it regulates the movement ofrobot arms1002,1003 and/or of the drives.

Medical work station1000 may be configured for use on apatient1013 lying on a patient table1012 to be treated in a minimally invasive manner by means ofend effector1100.Medical work station1000 may also include more than tworobot arms1002,1003, the additional robot arms likewise being connected to controldevice1004 and being telemanipulatable by means ofoperating console1005. A medical instrument or surgical tool (including an end effector1100) may also be attached to the additional robot arm.Medical work station1000 may include adatabase1014, in particular coupled to withcontrol device1004, in which are stored, for example, pre-operative data from patient/living being1013 and/or anatomical atlases.

With reference toFIGS. 20-29, another embodiment of asurgical suturing instrument500 is illustrated.Surgical suturing instrument500 is similar tosurgical suturing instrument100 described above, and will therefore only be described with the detail necessary to elucidate particular differences therebetween.Surgical suturing instrument500 generally includes ahandle assembly510, ashaft520 extending distally fromhandle assembly510, and anend effector530 that extends from adistal end portion520bofshaft520. Handle assembly510 ofsurgical suturing instrument500 includes ahandle housing511 supporting afirst trigger517 and asecond trigger519.

With reference toFIGS. 20-24,surgical suturing instrument500 includes anactuation bar529 having aproximal end portion529aoperably coupled to thesecond trigger519.Actuation bar529 terminates in adistal end portion529bthat is operably coupled to endeffector530 in a manner to rotate afirst jaw member534 ofend effector530 upon actuation ofsecond trigger519, as will be described in detail below. Theactuation bar529 has adrive pin538 extending perpendicularly throughdistal end portion529bthereof.Drive pin538 is configured to rotatefirst jaw member534 about a longitudinal axis “X” defined byshaft520.

End effector530 has a tubularouter body portion540 and aninner body portion542 disposed withinouter body portion540.Inner body portion542 ofend effector530 extends distally fromdistal end portion520bofshaft520 and is rotationally fixed relative toshaft520.Inner body portion542 ofend effector530 defines a longitudinally-extending slot544 (FIG. 24) through which drivepin538 ofactuation bar529 extends. An actuation ofsecond trigger519 is configured to advancedrive pin538 ofactuation bar529 throughslot544 ofinner body portion542.Outer body portion540 ofend effector530 is rotationally supported oninner body portion542 and defines ahelical cam slot546 through which drivepin538 ofactuation bar529 extends. Sincefirst jaw member534 ofend effector530 is fixed toouter body portion540, advancement ofdrive pin538 throughhelical cam slot546 ofouter body portion540 drives a rotation offirst jaw member534 about longitudinal axis “X.”

Surgical suturing instrument500 includes first andsecond push rods548,550, a bearingassembly552, and first and second elongate lockingelements554,556 cooperatively functioning to selectively lock a suture needle, such as, for example, acurved needle560, to one of the first orsecond jaw members534,536. First andsecond push rods548,550 each have aproximal end portion558,562 operably coupled tofirst trigger517 ofhandle assembly510. First andsecond push rods548,550 are configured to translate (e.g., move distally and proximally) in a direction parallel with the longitudinal axis “X” ofshaft520 in response to an actuation offirst trigger517. In some aspects, first andsecond push rods548,550 may be operably coupled to distinct triggers (e.g., triggers517 and519 respectively).First trigger517 is configured to simultaneously translatepush rods548,550 in opposite directions.

Bearing assembly552 includes anouter race564 and aninner race566 rotationally supported in theouter race564. Adistal end portion568 offirst push rod548 is fixed (e.g., via an adhesive or any suitable fastener) to theinner race566 of bearingassembly552. In some embodiments,distal end portion568 offirst push rod548 is fixed toouter race564 of bearingassembly552 instead ofinner race566. Due tofirst push rod548 being coupled to bearingassembly552, both inner andouter races566,564 of bearingassembly552 move distally withfirst push rod548.

The firstelongate locking element554 may have a rod-shape and extends between aproximal end portion554aand adistal end portion554b. Theproximal end portion554aof firstelongate locking element554 is coupled toouter race564 of bearingassembly552. In other aspects,proximal end portion554aof firstelongate locking element554 may be coupled toinner race566 of bearingassembly552 rather thanouter race564.Proximal end portion554aof firstelongate locking element554 has aconnector570 extending therefrom fixed toouter race564, such that asouter race564 rotates relative toinner race566, firstelongate locking element554 rotates therewith.Distal end portion554bof firstelongate locking element554 may have a substantially flattened, blade-like shape. Second elongate locking element556 is coupled tosecond push rod550.

Thefirst trigger517 is configured to simultaneously translate the first and second elongate lockingelements554,556 in opposite directions. For example, an initial actuation offirst trigger517 may cause firstelongate locking element554 to advance and second elongate locking element556 to retract.

First jaw member534 is monolithically formed withouter body portion540. In some aspects,first jaw member534 may be connected toouter body portion540.Second jaw member536 is fixed relative toinner body portion542. Due to the similarities between first andsecond jaw members534,536, only details with respect tofirst jaw member534 will be further described herein.

First jaw member534 andouter body portion540 ofend effector530 each define a coextensive, longitudinally-extendinggroove572 in which first elongate lockingelement554 is slidably supported.Distal end portion554bof firstelongate locking element554 is captured ingroove572, such that firstelongate locking element554 rotates withfirst jaw member534, wherebyouter race564 of bearingassembly552 is also caused to rotate. Due toproximal end portion554aof firstelongate locking element554 being coupled to bearingassembly552, firstelongate locking element554 is configured to translate relative to and withinfirst jaw member534 without inhibiting rotation offirst jaw member534.

First jaw member534 has a distal end portion (e.g., a distal tip) defining ahole574 therein in communication withgroove572.Hole574 extends at a perpendicular angle relative to groove572 and is configured for detachable receipt of afirst end560aofcurved needle560. When thefirst end560aofcurved needle560 is received inhole574,first end560aofcurved needle560 extends intogroove572 and into longitudinal alignment withdistal end portion554bof firstelongate locking element554.

With reference toFIGS. 25-28,first end560aofcurved needle560 defines afirst notch580atherein configured to receivedistal end portion554bof firstelongate locking element554.Second end560bofcurved needle560 defines asecond notch580btherein configured for removable receipt of a distal end portion of second elongate locking element556. In some aspects, thenotches580a,580bmay be formed at any suitable location ofcurved needle560.

FIG. 29 illustrates another embodiment of acurved needle660, similar tocurved needle560. Instead of having a continuous curvature along its length,curved needle660 has first and second linear ends660a,660binterconnected via a curvedintermediate segment660c.

In operation,second end560bofcurved needle560 is received in ahole577 ofsecond jaw member536 and the distal end portion of second elongate locking element556 is disposed withinsecond notch580bincurved needle560. Therefore, in this condition,curved needle560 is fixed tosecond jaw member536. To passcurved needle560 fromsecond jaw member536 tofirst jaw member534,second trigger519 may be actuated, wherebyactuation bar529 is moved distally throughshaft520.Drive pin538 ofactuation bar529 moves throughhelical cam slot546 ofouter body portion540 ofend effector530 to rotateouter body portion540 and the attachedfirst jaw member534 about longitudinal axis “X” toward an approximated position withsecond jaw member536.

Upon thefirst jaw member534 entering the approximated position,first end560aofcurved needle560 entershole574 infirst jaw member534, thereby aligningfirst notch580aofcurved needle560 withgrove572 infirst jaw member534. Withfirst end560aofcurved needle560 inhole574 offirst jaw member534,first trigger517 may be actuated to simultaneously advancefirst push rod548 and retractsecond push rod550. Advancingfirst push rod548advances bearing assembly552 and the attached first elongate lockingelement554 from a proximal, non-locking position to a distal, locking position. In the proximal position,distal end portion554bof firstelongate locking element554 is disposed proximally and out ofhole574 of thefirst jaw member534, whereas in the distal position,distal end portion554bof firstelongate locking element554 is disposed withinhole574 of thefirst jaw member534. Withfirst end560aofcurved needle560 disposed inhole574, advancement of thedistal end portion554bof the firstelongate locking element554 movesdistal end portion554bthereof intofirst notch580aoffirst end560aofcurved needle560, thereby lockingfirst end560aofcurved needle560 tofirst jaw member534.

Sincesecond push rod550 concurrently retracts with the advancement offirst push rod548,second push rod550 retracts the attached second elongate locking element556 out ofhole577 insecond jaw member536 at the same time thatdistal end portion554bof firstelongate locking element554 entershole574 infirst jaw member534. Therefore, the second elongate locking element556 exits thesecond notch580bin thesecond end560bofcurved needle560 to releasesecond end560bofcurved needle560 fromsecond jaw member536, allowingcurved needle560 to transfer tofirst jaw member534.

In embodiments, the first and second elongate lockingelements554,556 and theactuation bar529 may be actuated by the same trigger, such as, for example,first trigger517 orsecond trigger519. In such an embodiment, the actuation of the first and second elongate lockingelements554,556 is timed so that it occurs immediately afterfirst jaw member534 is approximated towardssecond jaw member536.

It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely exemplifications of embodiments. Those skilled in the art will envision other modification within the scope and spirit of the claims appended thereto.

Claims (20)

The invention claimed is:

1. A surgical suturing instrument, comprising:

a handle assembly;

a shaft extending distally from the handle assembly and defining a longitudinal axis;

an end effector including:

a first jaw member coupled to a distal end portion of the shaft, the first jaw member defining a hole and a longitudinally-extending groove in communication with the hole, the hole configured for detachable receipt of a curved needle; and

a second jaw member coupled to a distal end portion of the shaft and defining a hole configured for detachable receipt of the curved needle; and

a first elongate locking element having a distal end portion slidably received in the groove, wherein the first elongate locking element is configured to move between a proximal, non-locking position in which the distal end portion of the first elongate locking element is disposed proximally of the hole of the first jaw member, and a distal, locking position in which the distal end portion of the first elongate locking element is disposed within the hole of the first jaw member for locking the curved needle to the first jaw member, wherein the first jaw member is configured to rotate relative to the second jaw member and the shaft about the longitudinal axis of the shaft.

2. The surgical suturing instrument according toclaim 1, wherein the second jaw member defines a longitudinally-extending groove in communication with the hole of the second jaw member.

3. The surgical suturing instrument according toclaim 2, further comprising a second elongate locking element having a distal end portion slidably received in the groove of the second jaw member, wherein the second elongate locking element is configured to move between:

a proximal, non-locking position in which the distal end portion of the second elongate locking element is disposed proximally of the hole of the second jaw member for releasing the curved needle; and

a distal, locking position in which the distal end portion of the second elongate locking element is disposed within the hole of the second jaw member for locking the curved needle to the second jaw member.

4. The surgical suturing instrument according toclaim 1, wherein the hole of the first jaw member defines an axis that is perpendicular to an axis defined by the groove.

5. The surgical suturing instrument according toclaim 1, further comprising a curved needle, wherein the curved needle is configured for detachable receipt in the hole of each of the first and second jaw members.

6. The surgical suturing instrument according toclaim 5, wherein the curved needle has a first end defining a first notch configured for receiving the distal end portion of the first elongate locking element when the first end is in the hole of the first jaw member.

7. The surgical suturing instrument according toclaim 6, wherein the curved needle has a second end defining a second notch.

8. The surgical suturing instrument according toclaim 1, further comprising a bearing assembly including:

an outer race; and

an inner race supported in the outer race, wherein the first elongate locking element has a proximal end portion coupled to the outer race or the inner race.

9. The surgical suturing instrument according toclaim 8, further comprising a push rod coupled to the other of the outer race or the inner race for moving the bearing assembly and the first elongate locking element between the proximal and distal positions.

10. The surgical suturing instrument according toclaim 1, wherein the end effector includes an outer body portion rotationally coupled to the distal end portion of the shaft, the first jaw member fixed to and extending from the outer body portion.

11. The surgical suturing instrument according toclaim 10, wherein the end effector includes an inner body portion disposed within the outer body portion, the second jaw member coupled to a distal end portion of the inner body portion.

12. The surgical suturing instrument according toclaim 11, further comprising an actuation bar operably coupled to the handle assembly and configured to translate within the shaft in response to an actuation of the handle assembly, wherein the outer body portion defines a cam slot having a portion of the actuation bar received therein such that translation of the actuation bar rotates the outer body portion and the first jaw member relative to the inner body portion and the second jaw member.

13. A surgical suturing instrument, comprising:

a handle assembly including a first trigger;

a shaft extending distally from the handle assembly and defining a longitudinal axis;

an end effector including:

a tubular outer body portion rotatably coupled to a distal end portion of the shaft;

a first jaw member extending distally from the outer body portion, the first jaw member defining a hole configured for detachable receipt of a curved needle; and

a second jaw member coupled to a distal end portion of the shaft and defining a hole configured for detachable receipt of the curved needle; and

a first elongate locking element having a proximal end portion coupled to the first trigger, and a distal end portion, wherein the first elongate locking element is configured to move between a proximal, non-locking position in which the distal end portion of the first elongate locking element is disposed proximally of the hole of the first jaw member, and a distal, locking position in which the distal end portion of the first elongate locking element is disposed within the hole of the first jaw member for locking the curved needle to the first jaw member, wherein the first jaw member is configured to rotate with the outer body portion and relative to the second jaw member and the shaft about the longitudinal axis of the shaft.

14. The surgical suturing instrument according toclaim 13, wherein the first jaw member defines a longitudinally-extending groove in communication with the hole of the first jaw member, the distal end portion of the first elongate locking element slidably disposed in the groove.

15. The surgical suturing instrument according toclaim 13, further comprising a second elongate locking element having a distal end portion slidably received in the second jaw member, wherein the second elongate locking element is configured to move between:

a proximal, non-locking position in which the distal end portion of the second elongate locking element is disposed proximally of the hole of the second jaw member for releasing the curved needle; and

a distal, locking position in which the distal end portion of the second elongate locking element is disposed within the hole of the second jaw member for locking the curved needle to the second jaw member.

16. The surgical suturing instrument according toclaim 13, further comprising a curved needle, wherein the curved needle has a first end defining a first notch configured for receiving the distal end portion of the first elongate locking element when the first end is in the hole of the first jaw member.

17. The surgical suturing instrument according toclaim 16, wherein the curved needle has a second end defining a second notch.

18. The surgical suturing instrument according toclaim 13, further comprising:

a push rod having a proximal end portion coupled to the first trigger and configured to translate in response to an actuation of the first trigger; and

a bearing assembly disposed within the shaft and including:

an outer race; and

an inner race supported in the outer race, wherein the proximal end portion of the first elongate locking element is coupled to the outer race or the inner race and a distal end portion of the push rod is coupled to the other of the outer race or the inner race for moving the bearing assembly and the first elongate locking element between the proximal and distal positions.

19. The surgical suturing instrument according toclaim 13, wherein the end effector includes an inner body portion disposed within the outer body portion and rotationally fixed relative to the shaft, the second jaw member coupled to a distal end portion of the inner body portion.

20. The surgical suturing instrument according toclaim 19, further comprising an actuation bar operably coupled to a second trigger of the handle assembly and configured to translate within the shaft in response to an actuation of the second trigger, wherein the outer body portion defines a cam slot having a portion of the actuation bar received therein such that translation of the actuation bar rotates the outer body portion and the first jaw member relative to the inner body portion and the second jaw member.

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